My feature on male procedures in BusinessMirror

For the link to the article, CLICK HERE.

At this rate, he’s gonna look prettier than I do!

Written by Samito Jalbuena / the.beast@zoho.com

IT was the eleventh hour till the big day and the wedding was planned. But the groom went under the radar for a week-and-a-half, upsetting the bride-to-be. He only texted back and answered her calls, but he didn’t show himself when requested. On the eve of the wedding, he finally revealed the reason for the absence.

He had a nip and tuck. His eyelids were now more defined. Botox was done on his forehead. The bride was envious but was also approving. “At this rate, he’s gonna look prettier than I do,” she said.

“I’ll probably be the one to get on my knees this time around and propose that he marry me,” she chuckled. “I also feel cheated. I always thought that wives were supposed to be the first to get plastic surgery, not the other way around.”

The age of manhood has come full circle, or so it seems. Men have been getting out of their shell and into the plastic surgeon’s clinic, and it’s been happening in droves. Then comes the caveat: Should women be happy that their men are becoming more desirable, or should they be on guard?

“Men right now are taking the first step in putting their best look forward, often eschewing the barber shop for more exotic ‘cuts’. Nowadays they simply want to look great, not out of a sense of vanity but because the standards of image have simply gotten higher,” says Dr. Arnold Angeles, a Manila-based plastic surgeon who has noted the steady rise of male patients in the past years (www.arnoldangeles.com). “Men now make up more than 40 percent of my clientele from just below 6 percent a couple of years ago.”

What is wrong here?

The grandfathers of older generations might be dismayed that Sonny has lost the macho quotient to all this silicone. Where a chest of hair was once considered a man’s glory peeking out of a bomber jacket, nowadays you have a burgeoning chest, clearly hairless yet muscled and plump, courtesy of pectoral implants.  These silicone appointments are better than slaving in the gym for years, say the advocates. Implants give you the desired effect with minimal downtime. Duration of procedure: Roughly two hours. Healing: Give it a week.

Ray A. Gapuz is one of these advocates who believe that a definition of masculinity changes with the times. An author of internationally recognized books on passing the National Council Licensure Examination for Registered Nurses, Gapuz is also a licensed nurse, educator and founder of the RA Gapuz Review Center, a government-recognized test

Ray Gapuz: Now and then

preparations provider for aspiring nurses and other would-be professionals. Gapuz is not afraid to admit that he has undergone at least 10 procedures with Angeles, including eyelid surgery, liposuction, and cheek and pectoral implants. Why?

“Because it’s also good for the business,” one can guess about the entrepreneur who is also the brand ambassador of his review center. Indeed, the “new” Gapuz looks like a spring chicken compared to his previous incarnation. He has shed more than 50 pounds and looks 30 years younger via the wonders of Angeles’s scalpel and lipo-ready canula. For Gapuz, it was time to get some major renovations.

So what are the telltale signs that your man needs a nip and tuck?

“First, there are the signs of aging and obesity,” Angeles says. “The months directly after the holiday season are when a lot of revelers regret the weeks of binge-eating and binge-drinking. Also signs to watch out for: Look for sagging skin in all the wrong places. This translates to malicious eye bags, drooping ‘turkey’ necks and loss of volume on cheekbones. If someone tells you, ‘Man, you look so gaunt,’ then it’s time for a visit.”

Got drooping man-boobs? Don't be shy. The doctor will help you today. 

Second, Angeles notes that due to the rise of social media such as Google+, Facebook, Twitter and Instagram, more men are becoming aware of the importance of looking good for an audience. Plastic surgery often translates to a better image of themselves. “It means that their pictures become more, marketable, more viewable and more likely to get Likes or be shared,” the social-media savvy Angeles says. “The need for image marketing is a telltale sign that a man needs a nip and tuck.”

Performing "botox" on a male patient

These changes in attitude can be credited to the steady rise of incomes, the opening up of formerly gender-specific patterns of behavior, and the democratization of the clinical practice. The latter has lowered the prices of procedures while providing more specialized doctors, fueling the acceptability of plastic surgery for men. “In many ways, we are also closely following the trend that has occurred elsewhere in Asia,” says Angeles, who is one of Manila’s most respected young plastic surgeons. “As countries such as China and South Korea opened their economies, they also opened their markets to new ideas.”

Angeles knows what he’s speaking about. He was recently in a major Asian economy to conduct a symposium on how to apply facial fillers and botulinum toxin (commonly known in the genericized term “botox”).

“In their financial capital, I showed the foreign doctors how I assess patients who will need botox and fillers, then I performed both procedures on a patient. On the other hand, local plastic surgeons also showed how they do them, more of a technical thing, but the end point was the same: How to improve the patient’s looks despite his age and how to address his other plastic surgery needs.”

Angeles may not know it, but he may have become perhaps our first young goodwill ambassador of plastic surgery to another country.

This article and many others
may be found in the BLOG and PRESS areas.

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Lipo today

The popularity of liposuction exploded in the 1990s, and it quickly became the most commonly performed cosmetic surgery operation in the United States. An incomplete understanding of the physiology of the procedure, however, combined with greater volumes of suction and larger numbers of cases, led to unacceptable morbidity and mortality rates in the early years of liposuction.

To address these concerns, the American Society of Plastic Surgeons Committee on Patient Safety published the Practice Advisory on Liposuction in 2004. With the current understanding of physiology and safety, liposuction now has the lowest complication rate of any major plastic surgery operation. It is a common adjunct to abdominoplasty and breast surgery, and much safer today.

There's never been a more opportune time to get rid of fat through the wonders of liposuction.

For more on liposuction CLICK HERE for an earlier blog entry.

Also check out what the press says about my lipo technique HERE.

Last, read my special feature in BusinessMirror HERE.

It's best to avoid a situation like this!

According to a report from the Associated Press: 

Natasha Stewart, also known as Pebbelz Da Model, looks ahead while her attorneys
talk with the prosecutors and the judge over jury instructions during court
in Jackson, Miss., Friday, Jan. 31, 2014. She is charged with depraved-heart murder
in the death of 37-year-old Karima Gordon, of Atlanta. Stewart allegedly helped arrange
the unlicensed buttocks injections that prosecutors say killed Gordon in 2012.
The jury begun deliberations Friday. (AP Photo/Rogelio Solis)

JACKSON, Mississippi — A U.S. woman has been found guilty of manslaughter for the illicit silicone buttocks injections that prosecutors say killed a woman in 2012.

Natasha Stewart was found guilty Friday in the death of 37-year-old Karima Gordon.

Stewart had faced a murder charge, but the jury was told it could consider the lesser charge of manslaughter.

Authorities say Stewart, an adult entertainer also known as Pebbelz Da Model, took $200 for a referral to the alleged injector and falsely represented that the injector was a nurse.

WHAT TO DO?

Only go to a licensed, board-certified, press-media-approved and highly-trained plastic surgeon!

My feature in the Philippine Star

Here it goes, verbatim, from the June 19, 2013 issue of the Philippine Star newspaper, lifestyle section. Many thanks to writer Lai S. Reyes. For the link to the Star article, CLICK HERE.

How to face your facial woes

OOH LA LAI By Lai S. Reyes (The Philippine Star) | Updated June 19, 2013 - 12:00am

Dr. Arnold Angeles: “Creating facial symmetry, harmony and balance is very important because the right facial proportion contributes greatly to what is universally accepted as a beautiful face.”

The signs have been cropping up everywhere lately — on your face, eyes, hands, even in your heart and mind — but they’ve been too subtle to have a shocking impact, even after you have deciphered them fully.

The once-taut, smooth skin, full cheeks, prominent jawline, and full and well-defined lips have been magically erased by a potent potion called “time.” Before you know it, wrinkles start to form, skin becomes coarse, and freckles and sunspots appear. Your cheeks, brow and lips lose volume, which leads to sagging skin and jowls (the skin and fat that sag beneath the jawline) formation. Reality kicks in — you’re now officially “old.” But wait, you’re only pushing 30!

While no fountain of youth exists just yet, there are a variety of ways one can manage those undesirable marks of aging, which manifest in all the areas where we hope we could look young forever.

Look young, feel young

Juvederm Voluma with Lidocaine is fast becoming the treatment of choice among Asians with sagging skin.

In recent years, maintaining one’s facial symmetry and balance was a tall order for those who want to look young and stay beautiful. But today, in order to achieve those, it’s best to consult a licensed plastic surgeon/dermatologist, one who is dedicated to improving the quality of life of patients by enhancing or correcting facial and body features.

In creating facial symmetry, harmony and balance, these physicians are guided by what seem like mathematical equations.

“For example, we divide the face into three parts: from the hairline to the area of the eyebrows, from the eyebrows to the base of the nose, from the base of the nose to the chin. These three parts should relatively be equal in length; the upper lip should be thinner (1/3) than the lower lip (2/3). Creating facial symmetry, harmony and balance is very important because the right facial proportion contributes greatly to what is universally accepted as a beautiful face,” explains Dr. Arnold Angeles, a fellow and board member of the Philippine Association of Plastic, Reconstructive and Aesthetic Surgeons.

The correction of fine and dynamic lines, restoration of lips and cheek volume, and correction of nasal ethnicity are some of the facial problems Filipinos want to address.

“The younger set usually complains about some pigmentation and fine wrinkles starting to form, and wants their nose and chin corrected. For the older group, it’s wrinkles, sagging skin, and eye bags. Adding volume to the problem areas will rejuvenate the face, and, for the nose and chin, enhance one’s vertical profile, usually with little downtime and with natural-looking results,” notes Dr. Angeles.

So what are the popular treatments recommended/administered to patients who want to undergo facial enhancement without going under the knife?

“The most popular minimally invasive procedures for facial rejuvenation and enhancement are soft-tissue filler injection treatments,” explains the doctor.

According to Dr. Angeles, soft tissue fillers or dermal fillers treatments address specific facial problems. “Dermal fillers restore facial volume because they ‘fill’ the defect or the area where there is fat loss. Restoring volume brings the person closer to having a more youthful and vibrant look,” he explains.

Dermal fillers

Dermal fillers like Juvederm Voluma with Lidocaine are fast becoming the treatment of choice among Asians with sagging skin or volume deficit.

“Asians usually lose fat volume in the midcheek, and this gives them a ‘tired’ look. Injecting fillers like Juvederm Voluma with Lidocaine in this area will correct this problem and restore the ‘ogee curve’ that defines a youthful midface,” relates Dr. Angeles. The product can also be used to address a flat nose, for those who are afraid to or would rather not undergo surgery (rhinoplasty). 

“It may also be used to elongate the chin or give it more anterior projection (Asians usually have a small, retruded chin). Unlike surgery, there is minimum downtime with filler injections like Juvederm Voluma with Lidocaine. In fact, you can go to our clinic and report back to the office after. You may have bruising and negligible swelling that go away for just a few days,” explains Dr. Angeles.

With hyaluronic acid as its key ingredient, Juvederm Voluma with Lidocaine’s formulation helps temporarily restore facial volume that has diminished due to weight loss or age-related facial fat loss.

“Hyaluronic acid is a naturally occurring, biodegradable complex sugar found in the human body. If in any event, the patient does not like the result or if there is a need to ‘remove’ the filler, we can use hyaluronidase to degrade the filler (as compared to non-hyaluronic acid fillers). It is important to have these treatments done by board-certified plastic surgeons or dermatologists,” adds Dr. Angeles.

Dermal fillers restore facial volume because they “fill” the defect or the area where there is fat loss, creating a more youthful and vibrant look.

The effects of Juvederm Voluma with Lidocaine are temporary and, based on various clinical studies, its amazing aesthetic results last up to 24 months.

“Juvederm Voluma with Lidocaine has been found to last for 24 months, based on a clinical trial published this year. It is safe to have the treatment done several times; repeat sessions are safe as long as they are performed by physicians trained to do soft tissue filler injections,,” says Dr. Angeles.

One of the important things to also consider is good patient selection.

“Not all candidates are suitable for treatment with fillers. Proper assessment by the doctor is important. The doctor then should explain the procedure and what benefits the patient will get from the filler treatment. There are vast uses for fillers and they have to be used appropriately and wisely in order to have impeccable and successful results,” he adds.

Screenshot of article

The good thing about having a reputable doctor administer this filler to patients is that he/she can tell the latter when to continue or stop having treatment depending on the facial areas that require it.

“The most unwanted result is over-correction. A prudent and highly trained physician will be cautious not to ‘overfill’ his/her patient. As an injector, it is of utmost importance that we are well-versed with facial anatomy, aside from being well-trained with filler injections, so as to avoid adverse effects such as skin necrosis and ulcerations. Choose the right doctor, as well as the right product,” stresses Dr. Angeles, who uses Juvederm Voluma with Lidocaine for replacing volume loss in the temples, cheeks, and on the nose and chin.

While aging is inevitable, we can prevent its signs from manifesting with a little help from our doctor and Juvederm Voluma with Lidocaine.

* * *

Allergan is a multi-specialty health care company established more than 60 years ago with a commitment to uncover the best of science and develop and deliver innovative and meaningful treatments to help people reach their life’s potential. Today, we have more than 9,000 highly dedicated and talented employees, global marketing and sales capabilities with a presence in more than 100 countries, a rich and ever-evolving portfolio of pharmaceuticals, biologics and medical devices, and state-of-the-art resources in R&D, manufacturing and safety surveillance that help millions of patients see more clearly, move more freely and express themselves more fully. From our beginnings as an eye care company to our focus today on several medical specialties, including ophthalmology, neurosciences, obesity, urologics, medical aesthetics and dermatology, Allergan is proud to celebrate 60 years of medical advances and proud to support the patients and physicians who rely on our products and the employees and communities in which we live and work.

Pectoral Augmentation and Recovery

ONLY A REALLY GOOD PLASTIC SURGEON  KNOWS A MAN’S BODY REALLY WELL

This letter is addressed to you, the prospective client who wants to change his or her life today. It was written by Ray Gapuz to inspire you to take the first step.

Hi,

I’m Ray A. Gapuz, a certified regular client for aesthetic surgery and one of the many satisfied clients of DR. ANGELES.  So let me reassure you that you are in good hands if you have chosen Dr. Angeles to perform your surgery. In my case, I have undergone 10 procedures (including BLEPHAROPLASTY, LIPOSUCTION, CHEEK AND PECTORAL IMPLANTS, ETC.) 

Here are some helpful hints for those who are preparing for PECTORAL IMPLANT SURGERY. These helped me recover fast. I was able to return to my office meetings within 3 days after surgery. I hope this regimen will help you, too.

(Signed, Ray A. Gapuz)

PERSONAL THINGS TO PREPARE:Although valuables are looked after during your procedure, the clinic is not expected to   take responsibility for these items, so it’s best to only bring necessities. The following personal things are what I prepared for my personal use after the procedure.

·         Polo with buttons all the way to the front for ease of wearing after the surgery·         Bathrobe which you may prefer to use at discharge
·         Extra large sleeveless shirts ( sando) for everyday use after surgery

·         ‘Garterized’ shorts for a comfortable adjustment to the swelling

·         Bactidol gargle to counteract sore throat

·         Stretchable Corset (THAT SERVES AS ADDITIONAL SUPPORT TO THE COMPRESSION BANDAGE OR VEST) to minimize edema and pain when moving·         Battery-operated handheld mini massage machine helps minimize swelling

·         Call bell to facilitate communication with care provider

Preparations before surgery

Eat a  well-balanced diet

·         A well-balanced, healthy diet  aids healing and strengthens your immune system,leading to a faster recovery.

·        Take one  vitamin C a day which improves wound healing but avoid vitamin E intake for about two weeks prior to undergoing surgery, as it can interfere with blood clotting.

Do regular Exercise

·        By exercising, you increase your metabolic rate and build muscle mass which assists in avoiding weight gain during the recovery time. Check with your doctor which drugs are safe to take.From my personal readings I learned the following 

·        Two weeks prior to surgery: Stop vitamin E intake. Wheat germ, nuts, and some vegetable oils contain the largest amounts of vitamin E so avoid these for the two weeks before your surgery.

·        Seven days prior to your operation: Stop taking aspirin, clopidogrel (eg. Plavix, Iscover), dipyridamole (eg Asasantin, Persantin) and NSAIDs (non-steroidal anti-inflammatory drugs). The use of birth control pills, hormone replacement therapy and some forms of post-cancer treatment medication may also involve an increased risk of complications during or after surgery. Use of these types of medications may produce an increased risk of developing dangerous internal blood clots that can, in rare cases, lead to embolism.

·        Five days prior: Stop taking warfarin medications (Coumadin, Marevan). However, for high risk patients, stopping warfarin can lead to life-threatening blood clots and daily injections with low molecular weight heparin may be required. High risk patients most commonly include those with artificial heart valves or those who have suffered myocardial infarctions. Your doctor can advise if you are in the high risk category. Low risk patients stopping warfarin may require no course of action.

·        Stop eating at least six (6) hours before your procedure. However, you may continue drinking water and clear apple juice (and only clear apple juice) up to two (2) hours prior to your procedure.

·        On the day of your procedure: Shower and wash yourself with mild soap and shampoo your hair. Remove all jewelry.

·        Your own maintenance medication can be taken with a sip of water on the morning of surgery.

What to wear in the hospital

·        On the day of surgery, wear loose-fitting clothes (which do not have to be put on over your head).

·        Avoid using  aftershave, face cream or other cosmetics.

·        As contact lenses cannot be worn in the operating theatre, wear glasses, if required.

·        Please refer to the list of personal things needed in the aforementioned paragraph.

After Surgery

·        Dr. Angeles  will check you   after your surgery to ensure everything is going well. You will be able to go home a few hours later.

·        Some post-operative pain (varying from quite severe to mild or moderate) will occur on the first day. This gradually improves over the next few days and is usually well-tolerated by patients taking the prescribed painkillers. Increasing pain that is unresponsive to painkillers should be brought to the attention of Dr  Angeles as this may be an indication that complications are developing.

EXPECT DISCOMFORT DURING THE FIRST 24 HOURS

·         Pain-Take the prescribed pain medications and communicate a need for dose adjustment  to Dr. Angeles, if necessary

·         Muscle Fatigue-Massage the joint affected. Ensure that the extremity is properly positioned after the surgery.

·         Oozing-Apply additional gauze if necessary

·         Constipation – Increase fluids and fiber in the diet and move around as soon as you can.

AFTER 24 HOURS

·         Itchiness of the skin at the back due to the bandage, I used calamine lotion to manage it.

·         Swelling, I used the massage machine, cold compress in the first 48 hours and warm compress there after to lessen it.

·         Bruising , The SINECCH I bought at the clinic helped a lot.There was very minimal bruising because I took it as prescribed.

·         Numbness , I did squeezing exercises using a rubberball to minimize numbness of the arms and fingers.
·         Sometimes you may feel a lot of pressure on the chest area, as I did. This is due to the augmentation. Deep breathing may help.

·         It’s normal to feel burning, sharp shooting pain and soreness during the recovery.·         I was told that I will be swollen for a few months.which may affect the abdominal area and the legs. I am told that It’s normal for this to happen, it takes days for the swelling to go away, says Dr. Angeles.

DURING DRESSING TIME

·         Skin Irritation may result from the hypersensitivity of the skin after surgery especially when the anesthesia has worn off.

·         Dried wound tissues that attached to the gauze may cause pain. I used hydrogen peroxide to prevent unnecessary detachment of dried skin.

WOUND CARE PARAPHERNALIA

·         Hydrogen peroxide- facilitates changing of gauze

·         Lactcyd blue- used to wash the skin

·         Micropore tape- keeps the gauze in place

·         Fucidin antibacterial ointment-applied before the gauze is taped over the wound to prevent infection

·         Gauze protects the wound

CALL DR. ANGELES  IF ANY OF THE FOLLOWING DEVELOPS

·         Allergic Reaction

·         Pain that is not relieved by medications


·         Continuous bleeding

·         Dizziness

·         Feeling light headed

·         Abnormal temperature

·         Fever and chills

Before-and-after pics of another pec implant patient

ANY OF THESE MANIFESTATIONS MAY INDICATE THE DEVELOPMENT OF COMPLICATIONS

MANEUVERS THAT HELP DECREASE PAIN WHEN GETTING IN AND OUT OF BED

1.   Ensure that your care provider is there to assist you.

2.   Ask your care provider to place one hand at your back and the other hand will be for you to hold onto as you try to sit up.

3.   Flex one of  your legs

4.   At the count of 3, or any agreed signal,  push and step on your flexed leg as you hold onto your care providers’ arm and hold your upper body up.

5.   Sit and dangle your legs for a while before you stand up. This will help you stabilize your circulation first before you move as the anesthesia may cause your blood vessels to dilate that may cause dizziness when you abruptly change your position.

DO’S AND DONT’S DURING RECOVERY

DO’s

·         Sleep in an upright reclined position for 1-2 weeks. Elevate the head and shoulder on 2-3 pillows. This will help decrease the swelling.

·         Please take the medications as directed.  Never on an empty stomach and always space out the medications as instructed.

·          Start taking something to help prevent constipation 2-3 days post surgery.


DONT’s


·         Driving for 2-3 weeks post surgery or until off narcotic pain medication completely.

·         Reaching out or above  your head for at least 3-4 weeks.

·         Taking showers for 2-3 weeks post surgery or until drains are removed. No swimming for 12 weeks post surgery or until the incisions are fully healed.

·         Upper body exercising for 8-12 weeks post surgery.

·         Tanning or sun exposure to the incision until the incision has healed completely.·         Scar creams or ointments on the incision immediately after surgery, you may irritate the area or cause an allergic reaction.

·         Applying deodorant at the axillary area for at least 2 weeks or if the area looks red or is in the healing process.

AFTER EVERYTHING

·         Now, I’m enjoying my new chest

·         Wearing shirts is never the same. Shirts always shows my muscular cleavage now.

·         Flexing my pecs enhances the form

·         The feel and movements are all so natural

·         I show off my chest topless at pools and gym with confidence

·         More than anything else, this was a good decision and worth every spent.  I never could have had this chest doing gym exercises with my busy schedule.